Sahayaka”, are not provided with even basic training before their employment. Such personnel are thereby compelled to face the challenges of their work situations head on before understanding the nature and the type of patients that they will be dealing with. Their lack of preparation, exposure and awareness often results in unfortunate incidents that may be avoided. Relationship between the Parties The long-term residing patients exhibit good co-existence owing to the fact of their long stay at the facility, and the number of incidences reported are also low. However, a significant difference in the bahaviour can be seen in acute wards where the acutely disturbed patients and the new admissions are housed. There have been several reports of violence where the patients assault other patients within these wards. At such an instance if the situation is not de-escalated, the other patients could get aggressive as well, thereby further complicating the management of the situation. Even though the majority of the staff members’ treatment towards patients appeared friendly, it was stated that the attitude of some support staff members towards patients was flawed. They lack the patience to deal with mentally disabled persons and often lose sight of the fact that the patients are acting up due to their illnesses. There is currently no mechanism to identify and deal with such perception and behavior of the support staff. This is an additional indication of the need for training. It was also revealed that the division of different staff categoriesalso causes the relationship of the staff members to be distant thereby hindering the staff coordination. Grievance Mechanisms The notion of patient rights encompasses the obligations of the State and healthcare providers to respect the dignity, autonomy, and equality of care-seeking individuals in healthcare processes. In addition to the aforementioned concerns, ongoing rights violations of the patients were a significant concern. The disturbing incident of the death of a patient which is suspected to have been caused by support staff, and the use of poles in the particular incident raises the question as to how the patients are actually treated at the institution. It was revealed by some staff members that there are instances where the patients are subjected to scoldings and beatings at the hands of support staff. Furthermore, there have been complaints from medical students about the staff beating patients in CCTV blind spots. However, it was also observed by the Commission that there is a huge gap between the number of incidents that come to light and the incidents that go unnoticed. This is apparent upon reviewing the statistics put forth by the hospital. There is a reluctance of the staff members including the nursing staff and the doctors to report incidents and to reveal the actual perpetrators due to them relying fully on support staff to ensure their safety inside the wards. The patients and their families have the following options for the conveying of their grievances—they may complain to the Consultant during ward rounds, use the complaint boxes which are placed in front of the wards, complain directly to the Director, the Director General of Health Services, the police, and to the Human Rights Commission. Even though these options are available, many patients and their families seem unaware of these processes. 7|Page